SI Joint Dysfunction
The sacroiliac or SI joint is a load bearing, shock absorbing joint that lives between the spine and the pelvis. (1) It is the primary mechanical link between the lower body and the trunk. Dysfunction at the SI joint can be split into two categories; mechanical and arthritic. Arthritic SI joint dysfunction comes from an inflammatory process at the joint from an underlying arthritic pathology. Mechanical SI joint dysfunction comes from anything that changes normal joint mechanics. This can be a wide variety of things. Some of the most common causes are improper footwear, gait abnormalities, lower cross syndrome, poor spinal stability, repetitive overuse injuries, or even trauma to the region.
Individuals with SI joint dysfunction often feel pain over the joint that can refer into the low back, groin or down the thigh, although it rarely travels below the knee. Pain is often made worse by walking on that side and is better with shifting weight away from that side. Symptoms can also be provoked by rising from a seated position, especially after long car rides.
Treatment of SI joint dysfunction typically centers around manipulation of the SI joint to restore joint mobility. (2) Soft tissue techniques are used on the surrounding muscles to relieve muscle tension. Rehabilitation exercises are used to restore normal mechanics around the joint. Any underlying dysfunction such as gait abnormalities or lower cross syndrome must also be addressed.
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Sturesson BE, Selvik GO, Uden A. Movements of the sacroiliac joints. A roentgen stereophotogrammetric analysis. Spine. 1989 Feb;14(2):162-5
Nejati P, Safarcherati A, Karimi F. Effectiveness of Exercise THerapy and Manipulation of Sacroiliac Joint Dysfunction: A Randomized Controlled Trial. Pain Physician. 2019 Jan 1;22(1):53-61